By Lael Ewy, MFA, CPS
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| US Constitution, Photo courtesy Mr T in DC |
The most common issue we’ve encountered as we have explored
spirituality and mental health recovery comes from service providers who are
worried that they will run afoul of the 1st Amendment’s “establishment
clause” if they even approach the subject of a person’s spiritual life.
The actual clause reads thus: “Congress shall make no law
respecting an establishment of religion, or prohibiting the free exercise
thereof” (U.S. Const. Amend. I). Various interpretations of this amendment have
set the bar fairly high: working within the framework of Medicaid services
delivery, I am subject to a law Congress has made; therefore I ought to tread
carefully so that I am not seen as promoting a faith or prohibiting others’
exercise of their own. My own code of
ethics as a Certified Peer Specialist states that I shall not “practice,
condone, facilitate or collaborate in any form of discrimination,” including
against any particular religion (State of Kansas, cited in WSU-CCSR, 2006, p. 5),
an idea reinforced by the precept that I shall “at all times respect the rights
and dignity of those [I] serve.”
A quick look at the American Psychological Association’s
policy manual suggests similar guidelines, though they go on to note that the
APA “encourages collaborative activities in pursuit of shared prosocial goals
between psychologists and religious communities when such collaboration can be
done in a mutually respectful manner that is consistent with psychologists’
professional and scientific roles” (APA, 2007, p. 4).
Those shared goals mentioned by the APA suggest a direction
to go. And, with the usual caveats that I am not a lawyer and this is not legal
advice, we can at least explore a few ideas about how to approach a person’s
faith and spirituality as we move toward the shared goal of mental health
recovery.
Defer To Agency Policy
and Code of Ethics
First, and obviously, if you’re working for a mental health
center or other organization that has a specific policy regarding discussions
of religion and faith, defer to that. Defer, also, to your own professional
code of ethics.
Don’t Evangelize
This also ought to be obvious, but avoid trying to convert those
you serve. That’s covered by the policies against “discrimination” above. You
can discriminate against (“Your
religion is bad”), and you can also discriminate in favor of (“My religion is good.”). Neither is kosher ethically,
and both are unproductive. If we believe in self-determination, we are beholden
to be aware that with the position of service provider comes power and
authority, and to suggest to people how to believe in matters of faith is an
abuse of that power.
Their Faith (or Lack
Thereof) Is Their Own
Respect people’s right to practice (or not). That’s the
second part of the establishment clause, and it’s important not just to the aforementioned
notions of self-determination, but also because we each have different ways of
believing, even within a given religious tradition. You might share a faith
with someone you serve, but that does not necessarily mean that you experience
that faith in the same way. You might view the bosom of your church as a place
of solace and safety, but another might view it as a place of judgment and
shame and may find recovery easier if she stops going. That’s okay; it’s her
call. You can find out where she is on the subject by listening.
Listen
A big part of finding out when, if, and how a person wants
to talk about spirituality is to listen to what she says about it. This may
seem like a simple thing, but it’s sometimes hard to see through the cloud of
our own ideas about how spirituality ought
to work for people and see how it actually does. Our relationships with
spirituality, particularly those of us who grew up inside specific faith
traditions, are often as complex as the relationships we have with people—and
often as deep. To try to sum up my relationship with my Mennonite background as
good or bad, supportive or problematic, freeing or smothering, simply does not
meet the charge. It has been all those things at various times, sometimes
several all at once.
Ask
If by listening you pick up on the idea that a person’s
spiritual life is important to him, or that it is important to his recovery,
you have an indication that asking about it might be OK. Open-ended questions
can help determine what the person’s relationship with his spiritual life is
like and what he thinks it might do for (or against) him. At the right time,
questions like “What does being a Methodist mean to you?” or “How could your
mosque help support you in making this change?” could help a person get in
touch with spiritual resources or determine how one’s spiritual life might be
working at cross-purposes to his recovery.
Free Your Mind
Last, be open to the possibilities. Since everyone’s
experience of spirituality is unique, being open to what is going on for a
person spiritually and not pressing with interpretations of your own can lead
someone to self-discovery. Many people experience what psychiatry would label
symptoms as deep spiritual experiences. Even atheistic existentialists like
Jean-Paul Sartre spoke of “angst” as not merely a matter of personal experience
but as a result of a consciousness relating to the universe as a whole. One
woman’s vision may be, to a mental health practitioner, hallucination. If so,
they have little to discuss: the person having the experience may feel
dismissed and misunderstood, and the practitioner, by reducing the woman’s
experience to something that has no basis in reality, may be missing an
important insight into how that woman sees the world.
Profoundly spiritual experiences may even be disturbing, but
that does not necessarily mean they are unwelcome or bad to those going through
them; the least appropriate response may be to try to “treat” them or medicate
them away. Difficult spiritual experiences may be both deeply meaningful and an
avenue to a whole new life, a whole new way of thinking. Just about all religious
traditions have stories or rebirth through tribulation and trial, yet we are
terrified that any setback or difficulty is a treatment failure, not an
opportunity for growth. A respectful look through others’ spiritual lenses,
even though they might not be the ones through which we look, can help create
and maintain relationships of healing and of hope.
Following these points can turn what seem to be legal and
ethical restrictions into assets for the service relationship, creating safe
places in which people can express themselves freely without the fear of being
told their faith is wrong or that their mental distress is a source of shame.
It is also far from an exhaustive list. Please contribute
approaches that work for you in the comment box below. We’d love to hear from
you!
References
American Psychological Association. (2007). Resolution on religious,
religion-based and/or religion-derived prejudice. In The Council Policy Manual. Retrieved from http://www.apa.org/about/policy/religious-discrimination.pdf
U.S. Const. Amend. I
Wichita State University-Center for Community Support and
Research. (2006). Code of ethics. Kansas
Peer Specialist Basic Training Program for Certification: Facilitator’s Guide.
Wichita, KS: WSU-CCSR.
